Factors Associated with Decision Aid Use in Localized Prostate Cancer.

Area of Science:

• Urology
• Health Services Research
• Patient Decision Making

Background:

• Decision aids improve patient knowledge and reduce regret for cancer treatments.
• Widespread adoption of decision aids for newly diagnosed prostate cancer (PCa) remains limited.

Purpose of the Study:

• To investigate factors influencing men's decision to use a PCa decision aid.
• To identify patient and provider characteristics associated with decision aid uptake.

Main Methods:

• Retrospective analysis of a PCa registry (2018-21) from the Michigan Urological Surgery Improvement Collaborative (MUSIC).
• Included men with newly diagnosed, clinically localized PCa offered the Personal Patient Profile-Prostate (P3P) decision aid.
• Multilevel logistic regression analyzed P3P registration, accounting for patient and urologist factors.

Main Results:

• 45% of 2629 men registered for P3P.
• Urologist-level factors accounted for 41% of the variance in P3P registration.
• Patient-level factors explained only 1.5% of the variance; socioeconomic, literacy, and psychosocial factors were not included.

Conclusions:

• Urologist influence is a primary driver of decision aid adoption for PCa.
• Provider-level interventions are crucial to increase the use of decision aids.
• Further research should explore patient-specific barriers and facilitators.